Page 48 5.3.1 Therapeutic support How much support and personalization should be included in BC is a key question confronting optimal development of BC interventions and is of importance to scalable and effective translation. Clearly, it is of value to include a human support element from a healthcare provider, for instance to adequately assess risk and to deal with crisis situations (Berger & Andersson, 2009; Cuijpers, Riper, & Karyotaki, 2018). However, optimal types and levels of support are being tested and likely will depend on the client population and individual care needs, that is, type and severity of the primary issue. A recent meta-analysis on internet-based programs for depression found that not only was guided iCBT considerably more effective than self-guided iCBT, but the effect size was lowest for e-mail, intermediate for telephone, and largest when face- to-face support was provided, suggesting that more personal and synchronous support is associated with higher effects in this population (Wright et al., 2019). Another key question looks at who should be delivering this professional support. Evaluative studies have involved a diverse range of healthcare providers (e.g., primary care workers, psychologists, coaches) to deliver support and guidance, but few have compared types of providers or levels of training they have received. One systematic review found no significant effects when comparing different levels of training for coaches used alongside guided iCBT for MHD (Baumeister, Reichler, Munzinger, & Lin, 2014). A controlled trial that evaluated a guided digital intervention for anxiety disorders found that apart from GAD-7 scores, the coach-led and the clinician-led group showed no significant differences post-treatment (Johnson, Titov, Andews, Spence, & Dear, 2011). It is quite possible that the efficacy of type of provider may depend on the severity and complexity of the individual care needs. Consequently, a client with a milder mental health issue might readily benefit from working with a coach (rather than a psychotherapist) with adequate training regarding the specific treatment protocol adapted to BC. This idea is implemented by IAPT in the UK with the “stepped care model” that includes digitally enabled psychotherapy (National Collaborating Centre for Mental Health, 2021). Overall, much more comparative research is needed to determine the differential impact of type and level of support needed to maximize outcomes across BC interventions. [[Book - Digital Therapeutics for Mental Health and Addiction]]